Lung adenocarcinoma with Lambert-Eaton myasthenic syndrome indicated by voltage-gated calcium channel: A case report

Hiromasa Arai, Kenji Inui, Kazuki Hashimoto, Kazuki Kan-O, Teppei Nishii, Hitaru Kishida, Koji Okudela, Masahiro Tsuboi, Akinori Nozawa, Takeshi Kaneko, Munetaka Masuda

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Introduction. Lambert-Eaton myasthenic syndrome is a rare disorder and it is known as a paraneoplastic neurological syndrome. Small cell lung cancer often accompanies this syndrome. Lambert-Eaton myasthenic syndrome associated with lung adenocarcinoma is extremely rare; there are only a few reported cases worldwide. Case presentation. A 75-year-old Japanese man with a past history of chronic rheumatoid arthritis and Sjögren syndrome was diagnosed with Lambert-Eaton myasthenic syndrome by electromyography and serum anti-P/Q-type voltage-gated calcium channel antibody level preceding the diagnosis of lung cancer. A chest computed tomography to screen for malignant lesions revealed an abnormal shadow in the lung. Although a histopathological examination by bronchoscopic study could not reveal the malignancy, lung cancer was mostly suspected after the results of a chest computed tomography and [ 18F]-fluorodeoxyglucose positron emission tomography. An intraoperative diagnosis based on the frozen section obtained by tumor biopsy was adenocarcinoma so the patient underwent a lobectomy of the right lower lobe and lymph node dissection with video-assisted thoracoscopic surgery. The permanent pathological examination was the same as the frozen diagnosis (pT2aN1M0: Stage IIa: TNM staging 7th edition). Immunohistochemistry revealed that most of the cancer cells were positive for P/Q-type voltage-gated calcium channel. Conclusions: Our case is a rare combination of Lambert-Eaton myasthenic syndrome associated with lung adenocarcinoma, rheumatoid arthritis and Sjögren syndrome, and to the best of our knowledge it is the first report that indicates the presence of voltage-gated calcium channel in lung adenocarcinoma by immunostaining.

Original languageEnglish (US)
Article number281
JournalJournal of Medical Case Reports
Volume6
DOIs
StatePublished - 2012
Externally publishedYes

Keywords

  • Immunostaining
  • Lambert-Eaton myasthenic syndrome
  • Lung adenocarcinoma
  • Voltage-gated calcium channel

ASJC Scopus subject areas

  • Medicine(all)

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